Page 1889 - Saunders Comprehensive Review For NCLEX-RN

possible options. Use knowledge of anatomy and pain assessment to select the
correct option. Pain from renal cancer is a later finding and is localized in the flank
area.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Renal and Urinary
Health Problem: N/A
Priority Concepts: Clinical Judgment; Pain
Reference: Lewis et al. (2017), p. 1050.

644. Answer: 1, 3, 4

Rationale: Polycystic kidney disease is a genetic familial disease in which the
kidneys enlarge with cysts that rupture and scar the kidney, eventually resulting in
end-stage renal disease. Treatment options include hemodialysis or kidney
transplant. Clients usually undergo bilateral nephrectomy to remove the large,
painful, cyst-filled kidneys. Peritoneal dialysis is not a treatment option due to the
cysts. The condition does not respond to immunosuppression.
Test-Taking Strategy: Focus on the subject, treatment options for polycystic
kidney disease. Recall that the condition results in end-stage renal disease. This will
direct you to the correct options.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Planning
Content Area: Adult Health: Renal and Urinary
Health Problem: Adult Health: Renal and Urinary: Hereditary diseases
Priority Concepts: Clinical Judgment; Client Education
Reference: Ignatavicius, Workman, Rebar (2018), pp. 1381-1382.

645. Answer: 1

Rationale: The presence of blood at the urinary meatus may indicate urethral
trauma or disruption. The nurse notifies the PHCP, knowing that the client should
not be catheterized until the cause of the bleeding is determined by diagnostic
testing. The other options include performing the catheterization procedure and
therefore are incorrect.
Test-Taking Strategy: Focus on the subject, the complications associated with a
traumatic fall. Noting the words blood at the urinary meatus suggests more extensive
internal trauma that could be further aggravated by the catheterization.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Adult Health: Renal and Urinary
Health Problem: N/A
Priority Concepts: Clinical Judgment; Safety
Reference: Ignatavicius, Workman, Rebar (2018), p. 1369.

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